scholarly journals Clinical study on 7 cases of polypoid endometriosis. PEM: a mimic of malignancy, the symptoms of adenomyosis, endometrial polyps and infertility can assist in diagnosis

2021 ◽  
Author(s):  
Xiaohua Zheng ◽  
Ying Xu ◽  
xianjing chen ◽  
Qibing Zheng ◽  
Rong Zhao ◽  
...  
Keyword(s):  
Age Of Onset ◽  
Malignant Tumors ◽  
Clinical Manifestations ◽  
Pelvic Mass ◽  
Abnormal Uterine Bleeding ◽  
Diagnostic Methods ◽  
Pathological Examination ◽  
Rare Type ◽  
Endometrial Polyps ◽  
Polypoid Endometriosis

Abstract Objective: polypoid endometriosis (PEM) is a rare type of endometriosis (EMs), which is easy to be misdiagnosed. The purpose of this paper is to investigate the clinical features and diagnostic methods of PEM. Methods:The clinical data of 7 patients with PEM who were treated at Fujian Provincial Maternity and Children’s Hospital in China within July 2017 to December 2020 period were retrospectively analyzed, and their clinical characteristics, diagnosis, treatment and prognosis were summarized. Results: The age of onset was 31-41 (38.00 ± 1.72) years. There were 5 cases with adenomyosis, 4 cases with endometrial polyps and infertility. The clinical manifestations were diverse. Most of them were pelvic mass, compression symptoms and signs, dysmenorrhea and abnormal uterine bleeding, and three of them were similar to malignant tumors. The gross pathological features were cysts, endogenous or exogenous polypoid masses, which were all composed of endometrioid glands and stromal components, but more diverse than ordinary em. All the 7 patients were confirmed by operation and pathology. Conclusion: PEM is often complicated with adenomyosis, endometrial polyps and infertility. Pathological examination is the gold standard for diagnosis. Imaging examination is easy to be misdiagnosed. Abnormal increase of CA125 can assist in diagnosis.

Ultrasound features of polypoid endometriosis: a case report and a short review of Literature

2021 ◽  
pp. 228402652110530
Author(s):  
Matteo Mancarella ◽  
Luca Giuseppe Sgro ◽  
Luca Fuso ◽  
Paola Campisi ◽  
Nicoletta Biglia ◽  
...  
Keyword(s):  
Ultrasound Examination ◽  
Transvaginal Ultrasound ◽  
Pelvic Mass ◽  
Recurrent Abdominal Pain ◽  
Short Review ◽  
Pathological Examination ◽  
Surgical Removal ◽  
Histopathological Diagnosis ◽  
Histological Architecture ◽  
Polypoid Endometriosis

Introduction: Polypoid endometriosis is a rare variant of endometriosis characterized by histological features resembling an endometrial polyp. Lesions frequently affect the ovaries presenting as adnexal masses which may mimic malignancy, with an extremely complex differential diagnosis due to the poor evidence reported in Literature. Case description: In this report, we describe the case of a 43 years old woman referred to pelvic transvaginal ultrasound examination for recurrent abdominal pain, in whom sonography revealed a pelvic mass with features highly suspicious for ovarian carcinoma. Surgical removal allowed histopathological diagnosis of polypoid endometriosis, with no signs of malignancy. At ultrasound examination, the lesion appeared as a multilocular-solid mass, with low-level echogenicity of cystic content, multiple papillary projections, and solid areas with high vascularization and apparent infiltration of the uterus. At retrospective review of the sonographic images after pathological examination, some features mirroring the histological architecture of polypoid endometriosis could be identified in the solid components of the mass: these included the hyperechoic appearance, the rounded outline of the intracystic projections, and the vascularization pattern with a single central vessel with branching. Conclusions: To date, this is the first work providing a detailed ultrasonographic description of polypoid endometriosis using shared terms and definitions and relating these findings with available evidence about radiologic and histopathologic features. The report shows how this condition could strongly mimick ovarian malignancy, though several sonographic features can be identified reflecting the histopathological patterns of those lesions.

scholarly journals Study on TCM Syndrome Differentiation of Primary Liver Cancer Based on the Analysis of Latent Structural Model

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Zhan Gu ◽  
Xiuzhong Qi ◽  
Xiaofeng Zhai ◽  
Qingbo Lang ◽  
Jianying Lu ◽  
...  
Keyword(s):  
Liver Cancer ◽  
Structural Model ◽  
Malignant Tumors ◽  
Primary Liver Cancer ◽  
Clinical Manifestations ◽  
Active Role ◽  
Diagnostic Methods ◽  
Syndrome Differentiation ◽  
Statistical Validation ◽  
Tcm Syndrome

Primary liver cancer (PLC) is one of the most common malignant tumors because of its high incidence and high mortality. Traditional Chinese medicine (TCM) plays an active role in the treatment of PLC. As the most important part in the TCM system, syndrome differentiation based on the clinical manifestations from traditional four diagnostic methods has met great challenges and questions with the lack of statistical validation support. In this study, we provided evidences for TCM syndrome differentiation of PLC using the method of analysis of latent structural model from clinic data, thus providing basis for establishing TCM syndrome criteria. And also we obtain the common syndromes of PLC as well as their typical clinical manifestations, respectively.

scholarly journals Predictive factors of spontaneously regressed uterine endometrial polyps during the waiting period before hysteroscopic polypectomy

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Asuka Okamura ◽  
Eriko Yano ◽  
Wataru Isono ◽  
Akira Tsuchiya ◽  
Michiko Honda ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Drug Use ◽  
Spontaneous Regression ◽  
High Body Mass Index ◽  
Abnormal Uterine Bleeding ◽  
Pathological Examination ◽  
Endometrial Polyps ◽  
Waiting Period ◽  
Institutional Review ◽  
Small Polyp

Abstract Background The presence of uterine endometrial polyps is associated with not only abnormal uterine bleeding but also infertility, so the use of hysteroscopic polypectomy has been increasing. This operation is considered to increase cost-effectiveness when performed prior to infertility treatments. However, there are typical problems to consider, including the possibility of spontaneous regression of the polyp and the duration of complete endometrial wound healing after surgery. Meaningless interventions must be avoided, when possible. Therefore, data acquisition and analysis of various findings obtained from surgery have become important for improving treatment procedures and patient selection. To estimate the spontaneous regression rates and contributions of multiple factors to uterine endometrial polyps during the waiting period (approximately 2–3 months) before hysteroscopic polypectomy, we performed a multivariate analysis of data from the records in our hospital. Methods The medical records of 450 cases from September 2014 to April 2021 in our hospital were retrospectively reviewed under the approval of our Institutional Review Board. We included all cases of hysteroscopic polypectomy with postoperative pathological diagnosis. We defined cases as having a “spontaneously regressed polyp” when the target polyp was not detected by postoperative pathological examination. We extracted data on the following ten factors: “Advanced age” (≥ 42 years), “Small polyp” (< 10 mm), “High body mass index” (≥ 25 kg/m2), “Nulliparity,” “Single polyp,” “Infertility,” “Hypermenorrhea,” “Abnormal bleeding,” “No symptom,” and “Hormonal drug use.” We also classified cases into five groups according to the size of the polyp (≤ 4.9 mm, 5.0–9.9 mm, 10.0–14.9 mm, 15.0–19.9 mm, and ≥ 20.0 mm) and determined the frequency of spontaneously regressed polyp in each group. Results After exclusion of cases with insufficient data or other diseases, such as submucosal leiomyoma, 424 cases were analyzed. Among them, 28 spontaneously regressed polyps were identified, and the highest frequency of spontaneously regressed polyp was detected among the cases with polyps measuring 5.0–9.9 mm (16.4%). On multivariate analysis of the ten factors, “Small polyp” and “Hormonal drug use” were found to significantly impact the frequency of spontaneously regressed polyp. Conclusions On the basis of the factors identified in this analysis, the indications for observation or medical therapy adapted to small polyps might be expanded.

scholarly journals Case Report: Amyloidosis Cutis Dyschromica: Dermoscopy and Reflectance Confocal Microscopy and Gene Mutation Analysis of a Chinese Pedigree

2021 ◽  
Vol 8 ◽  
Author(s):  
Hui Wang ◽  
Zhenyu Zhong ◽  
Xiuli Wang ◽  
Liyun Zheng ◽  
Yifan Wang ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Clinical Manifestations ◽  
Gene Mutations ◽  
Reflectance Confocal Microscopy ◽  
Pathological Examination ◽  
Missense Mutations ◽  
Phenotype Correlation ◽  
Rare Type ◽  
Genotype Phenotype Correlation ◽  
Imaging Characteristics

Background: Amyloidosis cutis dyschromica (ACD) is a rare type of primary localized cutaneous amyloidosis. Non-invasive techniques can provide important clues for early diagnosis.Objectives: To highlight the characteristic imaging changes of ACD under dermoscopy and reflectance confocal microscopy (RCM), investigate gene mutations in a Chinese Han pedigree of ACD, and analyze the genotype–phenotype correlation.Methods: Dermoscopy and RCM examinations were completed together for the pedigree, and the imaging characteristics were described. The diagnosis of ACD was confirmed by pathological examination. Sequencing was performed followed by bioinformatics and genotype–phenotype correlation. ACD-related articles published on PubMed between January 1970 and March 2021 were reviewed and summarized.Results: In ACD, dermoscopy showed patchy white hypopigmentation and brownish spots, stripes, or hyperpigmented blotches and patches. RCM showed a highly refractive substance with clumpy, dotted, and linear structures inside the papillary dermis. Sequencing identified glycoprotein non-metastatic melanoma protein B (GPNMB) missense mutations [c.393T&gt;G (p.Y131X; NM_001005340.2)] and a frameshift deletion mutation [c.719_720delTG (p.V240fs; NM_001005340.2)]. The ANNOtate VARiation (ANNOVAR) software predicted that c.393T&gt;G is a pathogenic mutation. The literature review found 14 mutations, namely, 5 (35.7%) frameshift mutations, 4 (28.6%) non-sense mutations, 4 (28.6%) missense mutations, and 1 (7.1%) splice site mutation. Blisters and epidermolysis were observed in several cases, but there was no significant association between clinical manifestations and mutations in ACD.Conclusions: This study was the first to combine dermoscopy and RCM to describe ACD. Two GPNMB gene mutations were reported in a Chinese ACD pedigree. The genotype–phenotype correlation was analyzed for the first time; however, there was no significant correlation.

scholarly journals Clinical analysis of 68 patients with pulmonary mycosis in China

2019 ◽  
Vol 6 ◽  
Author(s):  
Bai-ling Luo ◽  
Le-meng Zhang ◽  
Cheng-ping Hu ◽  
Zeng Xiong
Keyword(s):  
Clinical Manifestations ◽  
Final Diagnosis ◽  
Clinical Analysis ◽  
Diagnostic Methods ◽  
Pathological Examination ◽  
Imaging Features ◽  
Pulmonary Cryptococcosis ◽  
Ct Guided ◽  
Pulmonary Mycosis ◽  
Nodular Lesions

Background: Due to the lack of specific clinical manifestations and imaging features, the diagnosis of pulmonary mycosis is difficult. This study aimed to investigate the pathogens, clinical manifestations, imaging features, diagnosis and management of pulmonary mycosis. Methods: Data on 68 patients diagnosed as pulmonary mycosis in Xiang Ya hospital from January 2001 to December 2010 were collected and their clinical manifestations, radiographic characterization, diagnostic methods and management were analyzed. Results: All patients were diagnosed by pathological examination. Of the 68 cases, 38 (55.9%) had pulmonary aspergillosis and 19 (27.9%) pulmonary cryptococcosis. Open-lung surgery was performed in 38 patients (55.9%), transbronchial biopsy in 15 (22.0%), and computerized tomography (CT)-guided percutaneous needle biopsy in 11 (16.2%). Main symptoms were as follows: cough in 51 cases (75.0%), expectoration in 38 (55.9%), hemoptysis in 25 (37.8%), fever in 20 (29.4%), while 6 cases (11.1%) were asymptomatic. X-ray and chest CT showed masses or nodular lesions in 52 cases (76.5%), patchy lesions in 10 (14.7%), cavity formation in 15 (22.0%), and diffuse miliary nodules in 1 case. In 51 cases (75.0%) misdiagnosis before pathological examination occurred. Surgical resection was performed in 38 patients (55.9%). In 25 patients (36.7%) systemic antifungal therapy was administered, and 20 patients (29.4%) experienced complete responses or partial responses. Conclusion: The main pathogens of pulmonary mycosis are Aspergillus, followed by cryptococcosis. Final diagnosis of pulmonary mycosis mainly depends on pathological examination. The clinical manifestations, imaging features, diagnostic methods and management differ depending on the pathogens. Satisfactory therapy can be obtained by both antifungal and surgical treatment.

Assessment of Clinical Symptomatology and Diagnostic Features of Intestinal Intussusception associated with Malignant Tumor in Children: Results of the Retrospective Non-randomized Controlled Study

2018 ◽  
Vol 5 (1) ◽  
pp. 41-50 ◽  
Author(s):  
Maria Yu. Yanitskaya ◽  
Ivan A. Turabov ◽  
Тatiana V. Turobova
Keyword(s):  
Weight Loss ◽  
Malignant Tumor ◽  
Clinical Picture ◽  
Malignant Tumors ◽  
Abdominal Mass ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Controlled Study ◽  
Tumor Identification ◽  
Abdominal Colic

Background. Treatment tactics for the intussusception (IS) in children is mainly defined the formation cause. Non operative IS treatment is most preferable. The surgery is often unreasonably performed in children over three years as the cause for IS occurrence can be a malignant tumor. Objective. Our aim was to define the features of clinical picture and diagnostics for IS associated with malignant tumors in children. Methods. We conducted the retrospective comparative assessment of reasons, registered clinical manifestations, and applied diagnostic methods in IS cases (n=373) at Arkhangelsk children's clinical hospital in 1981–2016. Two groups were analyzed: the first group (n=7) enrolled patients with IS caused by malignant tumor, the second one (n=366) — patients with IS caused by other reasons (idiopathic, mesenteric nodes hyperplasia, diverticulum, postoperative). Results. The typical combination was detected in the first group: symptoms of gastrointestinal tract (GIT) diseases and significant (8–12%) weight loss. In the first group, IS associated with tumor was observed in a few cases (1.9%), proceeded chronically (1–3 months), relapses did not occur, acute intestinal obstructions (р<0.001) were not registered; all the patients over five years were diagnosed with non-Hodgkin lymphomas if compare with the second group. The most informative diagnostic method was ultrasound imaging including hydrocolonic sonography which allowed IS diagnosing and tumor identification. In the second group, the clinical picture changed eventually: «triad» of symptoms typical for IS (abdominal colic pain, blood from rectum, abdominal mass) was registered in 1/3 of cases, significantly more often (p=0.001) the disease was demonstrated by «dyad» of symptoms (vomiting and abdominal colic pain) but always progressed to the acute form. Conclusion. The IS clinical course in children following its usual pattern significantly differs from the clinical picture associated with the tumor (though it occurs rarely, commonly in children over five years): the disease proceeds chronically with symptoms of GIT diseases and significant weight loss, relapses did not occur, no symptoms of acute intestinal obstruction are registered.

scholarly journals Histopathological study of endometrial stromal sarcomas

2018 ◽  
Vol 7 (12) ◽  
pp. 4891 ◽  
Author(s):  
Salma Bhat ◽  
Ambreen Beigh ◽  
Summyia Farooq
Keyword(s):  
Malignant Tumors ◽  
Endometrial Stromal Sarcoma ◽  
Abnormal Uterine Bleeding ◽  
World Health ◽  
Small Cells ◽  
Histopathological Study ◽  
Low Grade ◽  
Endometrial Polyps ◽  
Stromal Sarcoma ◽  
The Mean

Background: Endometrial stromal sarcomas (ESSs) are rare malignant uterine tumours comparatively affecting younger women and the mean age is 42 to 58 years. The World Health Organization (WHO) classification categorises endometrial stromal neoplasms and related tumors as: endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS), and undifferentiated uterine sarcoma (UUS).Methods: Present study is a retrospective one and includes 6 patients with histologically proven endometrial stromal sarcoma for a period of 3 years. Authors examined every slide available from each case and new HE-stained slides generated from formaline-fixed, paraffin-embedded tissue were reviewed to confirm the diagnoses. Demographic information, pathologic, and treatment information were collected from the clinic and hospital charts. All had primary surgical management in the form of total abdominal hysterectomy and salpingo-oophorectomy.Results: The mean patient age was 41 years. All of the patients had presented with abnormal uterine bleeding. Diffuse growth of small cells closely resembling those of the normal proliferative endometrial stroma was the characteristic feature of these tumors. All of these patients had a low grade ESS on histopathology. They had regular follow-up visits until the end of study.Conclusions: Endometrial stromal sarcomas are rare malignant tumors of the uterus and a proper preoperative diagnosis is difficult. Their differential diagnosis from typical submucosal uterine myomas or benign endometrial polyps can be difficult. The histological examination of the specimen is necessary to exclude malignancy and establish the final diagnosis.

Clinical-anamnestic analysis of the course and treatment of benign and borderline epithelial ovarian tumors

2016 ◽  
pp. 86-93
Author(s):  
M.Yu. Yegorov ◽  
◽  
A.A. Sukhanova ◽  
Keyword(s):  
Varicose Veins ◽  
Clinical Manifestations ◽  
Abnormal Uterine Bleeding ◽  
Abdominal Distension ◽  
Ovarian Tumors ◽  
Lower Limbs ◽  
Benign Tumors ◽  
Age Group ◽  
Venous Disorders ◽  
Serous Tumors

The objective: study the features of gynecological, physical history, diagnosis and treatment of patients with benign epithelial ovarian tumors (BeEOT) and borderline epithelial ovarian tumors (BEOT), determining the frequency of recurrence of ovarian tumors in the postoperative period. Patients and methods. According to a retrospective analysis of case histories of 112 women with epithelial ovarian tumors (EOT) underwent conservative or radical surgical treatment in a hospital, two groups were formed: I group – patients with benign epithelial ovarian tumors (BeEOT), which amounted to 85 (75.9%) women, and group II – patients with borderline epithelial ovarian tumors (BEOT), which amounted to 27 (24.1%) women. It was found that the main complaints of patients with EOT were pain (49.1%), abdominal distension (17%), and abnormal uterine bleeding (12.5%). The highest incidence of BeEOT (31.8%) observed in the age group of 41–50 years, while the peak incidence of BEOT (44.4%) corresponds to the age group of 51–60 years. Results. In BEOT endocrine pathology occurs significantly more frequently (p<0.05) than in BeEOT – 25.9% vs. 9.4%, respectively. Pathology of pancreatic-hepatobiliary system occurs significantly more frequently (p<0.05) in patients with BEOT compared with BeEOT – 81.5% versus 57.6%, respectively. Venous disorders (varicose veins of the pelvic organs, lower limbs, haemorrhoids) observed in BEOT significantly more frequently (p<0.05) than in BeEOT – 18.5% vs. 5.9%, respectively. EOT most often diagnosed in the period from 1 to 6 months after the first clinical manifestations with an average uptake of medical care 4.6±0.57 months. In assessing of peritoneal exudate cytogram the mesothelium cells are significantly more common for BeEOT (p<0.01) than BEOT – 79.4% versus 40.9%, respectively. Cervicitis is more likely significantly to occur in BeEOT (p<0.01) than in BEOT – 29.4% vs. 7.4%, respectively. The most common histological type among the benign tumors of the ovaries are endometriomas, which occurred in 48.2% of all BeEOT cases, and among the borderline tumors – serous tumors, which accounted for 59.3% of all BEOTs. Conclusion. The use of organ sparing surgery in EOT increases the risk of recurrence, especially in the case of endometrial histology or borderline variant of tumor. Key words: benign and borderline epithelial ovarian tumors, clinical-anamnestic analysis, diagnosis, treatment.

Etiological structure and diagnosis of abnormal uterine bleeding

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
G E Chernukha ◽  
I A Ivanov ◽  
Z N Efendieva ◽  
M R Dumanovskaya ◽  
A V Asaturova
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histological Diagnosis ◽  
Reproductive Age ◽  
Endometrial Polyps ◽  
Chronic Endometritis ◽  
Endometrial Pathology

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.

CLINICAL CASE OF SUCCESSFUL TREATMENT OF INFERTILITY IN A PATIENT WITH FAILURE IVF RESULTS IN ANAMNESIS

2020 ◽  
pp. 61-67
Author(s):  
Kalinkina O.B. ◽  
Tezikov Yu.V. ◽  
Lipatov I.S. ◽  
Aravina O.R.
Keyword(s):  
Assisted Reproductive Technologies ◽  
Transvaginal Ultrasound ◽  
Clinical Manifestations ◽  
Reproductive Function ◽  
Abnormal Uterine Bleeding ◽  
Clinical Situation ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Deficiency Anemia ◽  
Number Of Publications

Genital endometriosis is a disease of women of reproductive age, accompanied by infertility in 50% [1]. Adenomyosis can be considered as an endometriosis of the uterus. Histologically, this process is represented by ectopic, non-tumor endometrial glands, and stroma surrounded by hypertrophic and hyperplastic myometrium [2]. Adenomyosis is accompanied by pelvic pain of varying intensity as well as menstrual disorders [1]. The disease is accompanied by significant violations of reproductive function (infertility, unsuccessful attempts at pregnancy and miscarriage, abnormal uterine bleeding). Adenomyosis can be accompanied by a violation of the function of adjacent organs (such as the bladder, rectum). Often, one of the clinical manifestations of adenomyosis is the development of sideropenic syndrome, which is also caused by the development of chronic post-hemorrhagic iron deficiency anemia. This is accompanied by a deterioration in the general condition of patients, a decrease in their ability to work. Despite a large number of publications in Russian and foreign scientific sources devoted to this problem, reproductive doctors and obstetricians-gynecologists often underestimate the role of adenomyosis in pregnancy planning using assisted reproductive technologies. Without interpreting the anamnesis data obtained through an active survey, doctors do not prescribe additional methods for diagnosing this pathology, which is not complex and expensive. To confirm the diagnosis, a transvaginal ultrasound examination of the pelvic organs during the premenstrual period is sufficient. In cases that are difficult to diagnose, the MRI method of the corresponding anatomical area can be used. Underestimation of the clinical picture and under-examination of the patient did not allow prescribing timely correction of the pathology and led to unsuccessful attempts to implement the generative function using assisted reproductive technologies. The conducted examination with clarification of the cause of IVF failures and the prescribed reasonable treatment made it possible to achieve regression of endometriosis foci in this clinical situation, followed by the patient's ability to realize generative function.

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